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Contact Information

KETTERING AFFILIATED HEALTH SERVICES
2175 LEITER ROAD
SYCAMORE GLEN HEALTH CENTER
MIAMISBURG, OH45342
 Phone: 937-384-4300
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for KETTERING AFFILIATED HEALTH SERVICES

NPI Number 1588772776
LBN Legal business name KETTERING AFFILIATED HEALTH SERVICES
Authorized official TIMOTHY KO - (KETTERING HEALTH CFO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 08/28/2006
Last updated 08/06/2024 - More than a year ago
Identifiers
OH License # 6000
OH Medicaid 2244842
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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